Research literature indicates that wellness programs reduce health care costs, with reductions for large firms averaging $3.27 for every dollar spent on wellness programs, says a new policy brief from Health Affairs. In addition, studies show that health promotion programs at organizations of all sizes result in an overall reduction of about 25% in sick leave, health plan costs, and workers compensation and disability costs.

According to the 2011 Kaiser Family Foundation and Health Research and Educational Trust annual survey of employer health benefits, 67% of companies with 3 or more employees that offered health benefits also offered at least 1 wellness program. Slightly more than half (52%) also offered wellness benefits to spouses or dependents of employees.

Almost all companies with 1,000 or more employees offered 1 type of program. Larger employers usually run wellness programs themselves. For small companies, wellness programs typically are run by the same firms that administer the employer's health benefits plan or by another entity referred to as a third-party administrator.

Typical features of wellness programs are behavior modification programs, such as exercise, weight management, and tobacco cessation; changes in the work environment or provision of special benefits to encourage exercise and healthy food choices, for example, subsidized health club memberships; and health-risk assessments and screenings for high blood pressure and cholesterol health education, including classes or referrals to online sites for health advice.

Although incentives and disincentives prompt workers to participate in wellness programs, the evidence is mixed on whether the result is real improvements in health outcomes, says Health Affairs. To date, there have been no published, independent studies on how changes in premiums or cost sharing affect health outcomes.

The policy brief also includes information about compliance with federal and state requirements, conflict over programs that tie rewards or penalties to individuals achieving standards related to health status, and concerns with privacy issues.